Using routinely available electronic health record data elements to develop and validate a digital divide risk score Article Swipe
Jamie M Faro
,
Emily Obermiller
,
Corey Obermiller
,
Katy E. Trinkley
,
Garth Wright
,
Rajani S. Sadasivam
,
Kristie L. Foley
,
Sarah L. Cutrona
,
Thomas K. Houston
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/jamiaopen/ooaf004
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/jamiaopen/ooaf004
Background Digital health (patient portals, remote monitoring devices, video visits) is a routine part of health care, though the digital divide may affect access. Objectives To test and validate an electronic health record (EHR) screening tool to identify patients at risk of the digital divide. Materials and Methods We conducted a retrospective EHR data extraction and cross-sectional survey of participants within 1 health care system. We identified 4 potential digital divide markers from the EHR: (1) mobile phone number, (2) email address, (3) active patient portal, and (4) >2 patient portal logins in the last year. We mailed surveys to patients at higher risk (missing all 4 markers), intermediate risk (missing 1-3 markers), or lower risk (missing no markers). Combining EHR and survey data, we summarized the markers into risk scores and evaluated its association with patients’ report of lack of Internet access. Then, we assessed the association of EHR markers and eHealth Literacy Scale survey outcomes. Results A total of 249 patients (39.4%) completed the survey (53%>65 years, 51% female, 50% minority race, 55% rural/small town residents, 46% private insurance, 45% Medicare). Individually, the 4 EHR markers had high sensitivity (range 81%-95%) and specificity (range 65%-79%) compared with survey responses. The EHR marker-based score (high risk, intermediate risk, low risk) predicted absence of Internet access (receiver operator characteristics c-statistic=0.77). Mean digital health literacy scores significantly decreased as her marker digital divide risk increased (P <.001). Discussion Each of the four EHR markers (Cell phone, email address, patient portal active, and patient portal actively used) compared with self-report yielded high levels of sensitivity, specificity, and overall accuracy. Conclusion Using these markers, health care systems could target interventions and implementation strategies to support equitable patient access to digital health.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/jamiaopen/ooaf004
- OA Status
- gold
- References
- 23
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4407134695
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4407134695Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/jamiaopen/ooaf004Digital Object Identifier
- Title
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Using routinely available electronic health record data elements to develop and validate a digital divide risk scoreWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-12-26Full publication date if available
- Authors
-
Jamie M Faro, Emily Obermiller, Corey Obermiller, Katy E. Trinkley, Garth Wright, Rajani S. Sadasivam, Kristie L. Foley, Sarah L. Cutrona, Thomas K. HoustonList of authors in order
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https://doi.org/10.1093/jamiaopen/ooaf004Publisher landing page
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1093/jamiaopen/ooaf004Direct OA link when available
- Concepts
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Electronic health record, Computer science, Health records, Digital divide, Digital health, Data science, Data mining, The Internet, World Wide Web, Health care, Political science, LawTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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